As a new womens' lacrosse referee I initially had mixed feelings about the ongoing debate on the use of helmets in play. Listening to the discussion in referee training sessions that stressed the finesse of the game and the need of the referee to control or slow down play, verses the struggle I felt as a person having a medical degree and realizing the potential hazards of brain injuries, I tried to see both sides. Some people think that helmets will make the game more physical. But after my first official day as a referee standing on the sidelines watching my daughter’s middle school team begin their game, my beliefs became clear. Female lacrosse players need to wear helmets. During the first eight minutes of the game there were three injuries, one related to a child’s head and neck. This player had been checked from behind causing her neck to snap back. She then fell and hit her head on the turf. I witnessed every parent’s/referee’s/coach’s nightmare: a player down and seizing. To my dismay, this player returned to play in less than three weeks and went on to have another concussion and seizure. She is now barred from impact sports for the rest of her life. What I found out about my local school district surprised me and motivated me to try to educate parents and give people the best information possible. After speaking to the athletic trainers in my school district, I was made aware that high school students are given baseline concussion testing but younger players are not. We are now in the process of offering that testing to younger players. Also, while coaches can have in-person or online concussion training it seems that more could be done to help the coaches and parents become more informed about concussions. There are numerous issues that could explain the high incidence of concussions in women's lacrosse. One might be to consider the nutrition and health of girls playing the game today. Both men and women today are better nourished and physically stronger, faster and more powerful than the players of previous years. This has created a weight imbalance as some players can actually outweigh others by a large margin. The physics of combining speed and extra mass can lead to a dangerous combination. Equipment has also evolved to allow for lighter and faster sticks, causing unintended hits in some instances, I'm sure. Another factor is the increase in new players due to the popularity of the sport. Putting players of different skill levels in the same game can set up a difficult dynamic. It is important for players to be aware of their body position in space and reference to other players. This is a skill that comes with time and coaching. Coaching is another aspect of the game that helps teams work together better and control the speed of their game. Neck strengthening exercises can decrease the whiplash motion often caused by a hit to the cranial region. As for me, I have now completed my first season as a referee. I feel that helmets and proper body equipment in womens' lacrosse will make the game safer for everyone. My feeling is that there are too many factors that increase the potential for head injuries and we should mitigate them as best we can. While I realize helmets do not prevent concussions, I do believe they would be helpful to protect young women from unintended hits to the head. Dr. Lori McGowan is an Adjunct Professor of Biology at Harrisburg Area Community College in Harrisburg, Pennsylvania.

SEQUIM, Wash. -- Battle-tested and a little weary from last fall’s high school football season, Travis Anderson, an experienced EMT and paramedic John Riley, understand the nuances of concussions. Athletes who — if they are conscious – say they are ‘fine,’ coaches who may not be sure an athlete needs medical attention, and parents told by ER staff that rest is the prescription for recovery, trying to make sense of the mountain of hospital medical bills. They’ve seen it all, and it’s not easy. First responders like Anderson and Riley from Clallam County Fire District #3 in Sequim, Wash., are a luxury for school districts around the country. Part of a crew made up of paid staff and volunteers, they wait in the corners until given the signal by a coach or referee, or a player goes down and stays there. Like other on-field personnel they can’t see every impact and don’t always know if an athlete is deteriorating on the bench after a big hit. They depend on an educated coaching staff and fellow teammates for their cues. Anderson said,”We’d like to be called sooner rather than later. If there’s any question, especially with a suspected concussion, call us.” Too little care Only about 42 percent of high schools nationally employ athletic trainers, a dismal number in the eyes of many concussion experts who continue to advise against any school district or private organization offering contact sports without proper sideline medical care. Given the budget crises facing many school districts, it is not surprising so few heed this advice. But the challenges in rural areas are even greater. Long distances separate football fields from hospitals and fire stations can serve several high schools. Resources are simply too lean. Many sports-related concussions “Our fire department provides sideline staff for high school football games, and as many junior varsity games as we can. We consider it part of our community service effort and quite frankly, we feel strongly about protecting our student-athletes and their futures,” said District #3’s Fire Chief, Steve Vogel. His first responders have been on the sidelines at Sequim School District's games since 1982. Chief Vogel’s staff has a long history dealing with sports concussions. Former Sequim football player Adrien Gault suffered a catastrophic brain injury during a game in 2006 and was airlifted to a Seattle trauma center where doctors gave him a four-percent chance of survival. He continues to work through his recovery. This past fall, a Sequim student suffered a brain aneurysm during a Friday afternoon PE class and died a few days later. That same Friday there were six significant concussions on the football field a few hundred yards away, said a well-informed source, turning the field into a war zone. Fire District #3 was there for it all. “There were more concussions during that one game than I’ve seen in my entire career, including my time as a running back in high school,” said Anderson. “It was a rarity.” Neither he nor Riley, who played tight end in high school remember suffering concussions during their football careers. They believe they’re seeing so many due to increased awareness trickling down from the NFL. Anderson said, “I think the attention on the concussion issue in the NFL is having an affect on all levels of the game, all the way down to the youngest players.” Emergency Medical Services for Children (EMSC) Guidelines and training for first responders come in the form of online education modules and concussion-related drills practiced several times a year. Soon-to-be-released state protocols developed by emergency room physicians, critical care nurses, EMTs, and others who make up the state committee of the federal Emergency Medical Services for Children program include a sports-concussion guide for first responders. Upon distribution, this document will provide a handy reference for those who attend youth and high school athletic events. “The Emergency Medical Services for Children (EMSC) program works to ensure proper pediatric care is available on ambulances and in hospital emergency departments nationwide,” said Ian Weston, Co-Director of the EMSC program headquartered in suburban Wash. D.C. “Emergency care providers are integral in ensuring our children get the right care when it counts.” When to call 911 Concussion symptoms can be subtle and may not appear right away, leaving room for mistakes to be made if athletes are not properly monitored when a concussion is suspected. The following are symptoms that require a call for emergency evaluation: •headaches that worsen •seizures •neck pain •very drowsy, can't be awakened •repeated vomiting •increasing confusion or irritability •weakness, numbness in arms and legs •unable to recognize people/places, less responsive than usual For more information see Should we call 911?, signs and symptoms Photo: (L) John Riley (firefighter/paramedic); (R) Travis Anderson (firefighter/EMT) Questions/comments? contact Jean Rickerson at jean@SportsConcussions.org

SEQUIM, Wash. -- Battle-tested and a little weary from last fall’s high school football season, Travis Anderson, an experienced EMT and paramedic John Riley, understand the nuances of concussions. Athletes who — if they are conscious – say they are ‘fine,’ coaches who may not be sure an athlete needs medical attention, and parents told by ER staff that rest is the prescription for recovery, trying to make sense of the mountain of hospital medical bills. They’ve seen it all, and it’s not easy. First responders like Anderson and Riley from Clallam County Fire District #3 in Sequim, Wash., are a luxury for school districts around the country. Part of a crew made up of paid staff and volunteers, they wait in the corners until given the signal by a coach or referee, or a player goes down and stays there. Like other on-field personnel they can’t see every impact and don’t always know if an athlete is deteriorating on the bench after a big hit. They depend on an educated coaching staff and fellow teammates for their cues. Anderson said,”We’d like to be called sooner rather than later. If there’s any question, especially with a suspected concussion, call us.” Too little care Only about 42 percent of high schools nationally employ athletic trainers, a dismal number in the eyes of many concussion experts who continue to advise against any school district or private organization offering contact sports without proper sideline medical care. Given the budget crises facing many school districts, it is not surprising so few heed this advice. But the challenges in rural areas are even greater. Long distances separate football fields from hospitals and fire stations can serve several high schools. Resources are simply too lean. Many sports-related concussions “Our fire department provides sideline staff for high school football games, and as many junior varsity games as we can. We consider it part of our community service effort and quite frankly, we feel strongly about protecting our student-athletes and their futures,” said District #3’s Fire Chief, Steve Vogel. His first responders have been on the sidelines at Sequim School District's games since 1982. Chief Vogel’s staff has a long history dealing with sports concussions. Former Sequim football player Adrien Gault suffered a catastrophic brain injury during a game in 2006 and was airlifted to a Seattle trauma center where doctors gave him a four-percent chance of survival. He continues to work through his recovery. This past fall, a Sequim student suffered a brain aneurysm during a Friday afternoon PE class and died a few days later. That same Friday there were six significant concussions on the football field a few hundred yards away, said a well-informed source, turning the field into a war zone. Fire District #3 was there for it all. “There were more concussions during that one game than I’ve seen in my entire career, including my time as a running back in high school,” said Anderson. “It was a rarity.” Neither he nor Riley, who played tight end in high school remember suffering concussions during their football careers. They believe they’re seeing so many due to increased awareness trickling down from the NFL. Anderson said, “I think the attention on the concussion issue in the NFL is having an affect on all levels of the game, all the way down to the youngest players.” Emergency Medical Services for Children (EMSC) Guidelines and training for first responders come in the form of online education modules and concussion-related drills practiced several times a year. Soon-to-be-released state protocols developed by emergency room physicians, critical care nurses, EMTs, and others who make up the state committee of the federal Emergency Medical Services for Children program include a sports-concussion guide for first responders. Upon distribution, this document will provide a handy reference for those who attend youth and high school athletic events. “The Emergency Medical Services for Children (EMSC) program works to ensure proper pediatric care is available on ambulances and in hospital emergency departments nationwide,” said Ian Weston, Co-Director of the EMSC program headquartered in suburban Wash. D.C. “Emergency care providers are integral in ensuring our children get the right care when it counts.” When to call 911 Concussion symptoms can be subtle and may not appear right away, leaving room for mistakes to be made if athletes are not properly monitored when a concussion is suspected. The following are symptoms that require a call for emergency evaluation: •headaches that worsen •seizures •neck pain •very drowsy, can't be awakened •repeated vomiting •increasing confusion or irritability •weakness, numbness in arms and legs •unable to recognize people/places, less responsive than usual For more information see Should we call 911?, signs and symptoms Photo: (L) John Riley (firefighter/paramedic); (R) Travis Anderson (firefighter/EMT) Questions/comments? contact Jean Rickerson at jean@SportsConcussions.org

President Obama's recent remarks regarding concussions in football reopened the discussion of the safety of the game just days before Super Bowl Sunday. In an interview appearing in the New Republic Obama says, "If I had a son, I'd think long and hard before I let him play football. And I think that those of us who love sports are going to have to wrestle with the fact that it will probably change gradually to try to reduce some of the violence." Leaders from sports-related organizations including pee-wee, high school, college and professional have worked for several years now to understand the injury, provide guidance to athletes and coaches, and fund research related to the effects of brain trauma. Changes have been broad and deep. NFL Commissioner Roger Goodell has surrounded himself with the most well-respected medical professionals in the concussion field, seeking their council. As co-chairmen of the NFL Head, Neck and Spine Committee, Drs. Richard Ellenbogen (chief of neurosurgery, Univ. of Washington) and Hunt Batjer (President of the Neurological Society of America) have assembled an impressive team, including senior adviser Dr. Robert Cantu, co-director Center for the Study of Traumatic Encephalopathy. Chronic traumatic encephalopathy, or CTE, is a degenerative brain disorder suspected to be associated with repetitive hits to the head. Previously only diagnosed post-mortem, evidence of the disease was recently found in five former NFL players who took part in a groundbreaking diagnostic study at UCLA. The committee is also actively involved in improving on-field recognition and assessment policies, helmet technology, and brain impact research. In 2011, the NFL dedicated over $100 million over the next decade to medical research, with the vast majority of those dollars committed to the science of concussions, their prevention and care. Concussions have always been a part of sports, and have never been limited to football. Soccer, volleyball, wrestling, lacrosse, bicycling, and yes, playground activities can all cause concussive injuries. Girls are at risk as much as boys. Seniors and soldiers suffer too. Change of this magnitude takes time. Those athletes who have paid the price through their individual suffering are heroes, having opened the door for the rest of us, exposing an issue whose time is due. Former NFL linebacker Junior Seau, who tragically took his own life in 2012 at age 43, was later diagnosed with CTE, which many believe contributed to his death. He and the other NFL, NHL and professional boxers who died at a young age and were later diagnosed with CTE, have commanded our attention. In 2006, Zachery Lystedt suffered a debilitating brain injury during a middle school football game at age 14, and now fights daily to escape his wheelchair. Zachery, with the help of Commissioner Goodell and the NFL, led us to develop legislation in almost every state helping to safeguard youth athletes from the effects of concussions. Zach's hero, Baltimore Ravens Ray Lewis will play in Sunday's Super Bowl. Zach and the estimated 111 million viewers will watch a safer game, one that is still evolving, striving to maintain the integrity of the contest while preserving the health of its players for the future. Thankfully, visionaries like Commissioner Goodell appear in the right place at the right time. Under his leadership the NFL has, and is, providing a road map and the necessary funding to investigate the questions and find solutions that will improve our understanding of risk as it applies to protecting our youth, preserving the competitive spirit, and honoring the bonds that bind us as teammates and fans. Photo courtesy: Creative Commons; copyright dcJohn 2004

Coy Wire was a team captain for the Buffalo Bills (2002-2007) and the Atlanta Falcons (2008-2011) during his nine years in the NFL. An All-American Honors athlete at Stanford University, Coy was the first player to lead the Cardinal in both rushing and tackles. He was a recipient of the NFL’s Ed Block Courage Award. Q: What would you tell athletes about concussions? The NFL is in a state of evolution and recent changes will only make it safer for younger athletes. The league and the NFLPA (National Football League Players’ Association) have made huge strides to address the concussion issue, while maintaining the excitement of the game for both fans and players. It’s important that all athletes remember that you only get one brain and as we learn more about the long-term and adverse effects of contact sports and repetitive head injury, we know that smaller hits over the course of a career- even a high school career- can accumulate. Learn to recognize the symptoms of head trauma. You can have headaches or you might be slightly dizzy …these are all bearable and many athletes mask these symptoms by taking a Tylenol and then they go out and play again. But a concussion is not an ankle or shoulder injury…later in life you can have surgery on that ankle or have knee replacement surgery but you only get one brain. You can’t get a brain replacement. If you mask head trauma you can be risking increased problems in the future for Alzheimer’s or dementia. Head trauma has to be looked at very differently. Yes, in a way it’s a body part like a shoulder, but your brain must be treated very differently. You can ice and elevate an ankle but can’t do that with your brain. Real damage may show up later in life …and it’s not just football, it can happen in any sport. We used to look at toughness and playing through injuries as a badge of honor. That you were tough both mentally and physically and that continuing to play while hurt brought you the respect of your peers. But we need to change the culture now, and that starts with you. You need to believe that it’s OK to miss a game or a week or longer. If you do have to sit out, it means you were playing hard and you took one for the team. You shouldn’t feel ashamed. And if you care about your friends and your teammates, keep them from harm.https:// If you see a friend of yours doing something to hurt themselves, like playing with a concussion, step up and help them. You’re doing them a huge injustice by allowing them to continue to play. You are your brother’s keeper. Become a hero in their life and help them realize what they probably know deep down inside anyway. Someday they’ll look back and know what you did for them, and they’ll respect you more, later in their lives. Be a leader and help change the game. Help create a new norm. Coy Wire is the author of Change Your Mind; 10 Unconventional Secrets to Retrain Your Brain; March 2012. He is an inspirational speaker and mind coach. For more information contact him at https://www.coywire.com/

SportsConcussions.org Named One of Constant Contact’s 2011 All Stars SportsConcussions.org recognized for achieving exemplary marketing results SEQUIM, Wash. — April 4, 2012 – SportsConcussions.org, a non-profit concussion education organization, has received the 2011 All Star Award from Constant Contact®, Inc., the trusted marketing advisor to more than half a million small organizations worldwide. Each year, a select group of Constant Contact customers are honored with the All Star Award for their exemplary marketing results. SportsConcussions.org’s results ranked among the top 10% of Constant Contact’s customer base. “We’re pleased to be recognized by Constant Contact for achieving strong marketing results, said Jean Rickerson, CEO and Founder of SportsConcussions.org. “Constant Contact’s tools have helped us reach a large audience with the all-important message regarding sports-related concussions in a very efficient way. We look forward to increasing our communication efforts even more in the coming year, to help protect more athletes. We are very grateful to all of our customers who follow us on our website, on social media and through our weekly newsletter. Our goal is to provide them with ideas and resources so they can protect athletes in their local communities.” Constant Contact looked at the following criteria to select this year’s All Stars: · Frequency of campaigns, events, and surveys · Open, bounce, and click-through rates · Event registration rates · Survey completion rates · Use of social features · Use of mailing list sign-up tools “There is nothing we like more than to see our customers finding success. It’s the reason Constant Contact was founded, and it’s a thrill to see the fantastic results that our All Stars are achieving,” said Gail Goodman, CEO of Constant Contact. “This group is really leading the charge when it comes to delivering relevant, engaging content that drives real business results. We salute this year’s All Stars for their success, and are honored to have played a part in their achievements.” About SportsConcussions.orgSportsConcussions.org is a non-profit organization dedicated to raising awareness about sports-related concussions. According to the Centers for Disease Control and Prevention (CDC) up to 3.8 million people suffer from a recreation- or –sport related concussion each year. SportsConcussions.org is anchored by a website that is update daily, featuring news, ideas and resources for school districts, leagues, coaches, parents and athletes. The organization also holds community workshops and conferences, and establishes baseline testing programs. About Constant Contact, Inc. Constant Contact is revolutionizing the success formula for small organizations through affordable, easy-to-use Engagement MarketingTM tools that help create and grow customer relationships. More than half a million small businesses, nonprofits, and associations worldwide rely on Constant Contact to drive ongoing customer dialogs through email marketing, social media marketing, event marketing, and online surveys. All Constant Contact products come with unrivaled KnowHow, education, and free coaching with a personal touch, including award-winning customer support.

As the on-ice passion of the NHL playoff games intensifies so do the penalties, particularly for vicious hits to the head. Saturday's games resulted in three separate incidents that will highlight the league's commitment to cracking down on illegal hits that may, and often do, cause concussions. Brendan Shanahan, Senior Vice President, Player Safety and Operations held hearings on two of the three violations Sunday afternoon. The third is scheduled for Monday. The hits are reviewed on video and the suspensions are explained in great detail by Shanahan on the NHL network (see videos below). Shanahan suspended New York Rangers forward Carl Hagelin for an illegal hit that forced opponent Daniel Alfredsson's head into the glass. Alfredsson, the Senators captain, left the game for evaluation and his status for the rest of the playoffs is uncertain. On Monday the team announced he had suffered a concussion on the play. This is Hagelin's first major penalty. The Wall Street Journal reports that disciplinary action against Hagelin may increase if Alfredsson, who has a history of concussions, is unable to return to the series. A one-game suspension was also issued Sunday for Ottawa Senators defenseman Matt Carkner for continuing to pummel an "unwilling opponent," Rangers forward Brian Boyle, who was knocked to the ice after Carkner delivered two powerful blows to his head. Carkner continued to hit Boyle as he lay on the ice. Boyle did not return the punches. Carkner was classified as an "aggressor" under NHL rules and was assessed a minor penalty for instigating, a major penalty for fighting and a game misconduct. Blackhawks forward Andrew Shaw is scheduled for a hearing on Monday for a shoulder-to-head hit on Coyotes goalie Mike Smith that left him down on the ice writhing in pain. Shaw earned a charging major and game misconduct on the play. Smith remained in the game. Last Thursday, Vancouver Canucks forward Byron Bitz was suspended for two games for a vicious hit to the head on Los Angeles Kings forward Kyle Clifford the night before. Clifford's head was shoved into the glass causing him to miss at least one game. In addition to the suspension Bitz was assessed a major penalty for boarding and a game misconduct the night of the game. Carl Hagelin/ Daniel Alfredsson Matt Carkner/ Brian Boyle Byron Bitz/ Kyle Clifford Source: NHL Network Questions/comments? Contact Jean Rickerson at jean@SportsConcussions.org

Researchers at Nationwide Children's Hospital in Columbus, Ohio, found that of the 14,635 high-school sports injuries reported during the 2008-2010 school year, 13% were concussions. The majority of them were uncomplicated, in fact, 40% of the students who suffered concussions saw their symptoms disappear within three days. Most returned to play within three weeks, but a significant number -- about 25% -- returned to play the same day they were injured, a situation many state concussion laws are designed to address. "This improper practice was widespread," noted researchers Mallika Marar, Natalie McIlvain, Sarah Fields and R. Dawn Comstock, who found it in 12 of the 20 sports they studied. "This clearly violates the consensus statement on sports-related concussion, which recommends that no adolescent athlete who sustains a concussion should return to play on the day of the injury,"reported WPTV.com. Other findings included: Most common symptoms: headache (94.2%), dizziness (75.6%) and difficulty concentrating (54.8%) More than one: Eleven percent had suffered concussions before, highest rate of recurrence was boys' wrestling (20%) Most by number: football (47%) followed by girls' soccer (8.2%) Most common practices/games: games; exception was cheerleading, participants were 10x more likely to be hurt during practice Most by gender: boys; although concussions in girls' sports represented a higher number of overall injuries Most common occurrence: athlete-to-athlete contact; girls were more likely to suffer a concussion from striking the ground or being struck by another players' piece of equipment such as a hockey stick The study was published in the January edition of the American Journal of Sports Medicine. Source: Study: High school athletes return from concussion too soon -- WPTV.com Questions/comments? Contact Jean Rickerson at Jean@SportsConcussions.org

Concern over longevity issues stemming from a string of injuries including back-to-back concussions, may have contributed to Chris Owusu's omission from the first seven rounds of the NFL draft this weekend. But Stanford's talented receiver, who turned in one of the fastest times in the 40-yard dash at the NFL Combine in February and was considered a possible top 100 prospect during his senior year, was signed by the San Francisco 49ers shortly after the draft concluded on Saturday. Owusu, one of Andrew Luck's go-to receivers missed the end of his senior season including two Bowl games after suffering two concussions in three weeks, his third in a little more than a year. Admitting to frustration because his symptoms cleared rapidly after each injury, he was not authorized by Cardinal physicians to return. Considered a third-round talent, Sports Illustrated's Jim Trotter spoke to several general managers about Owusu. "He's off our board," says one general manager. "He was from the start. It wouldn't matter if he was RG3, he'd still be off our board. With that kind of history it's not worth the risk of him being seriously injured, especially with all the attention you're going to receive. If you draft him you're going to be under the microscope the whole time. Every time he gets hit it's going to be magnified tenfold." For the 49ers, Owushttps://oo good to pass up. "Chris wasn't wiped off our board," 49ers general manager Trent Baalke said Saturday when he met the media at the conclusion of the draft. "You've got to remember, he was cleared to play by the same group of doctors that work with us on a regular basis. He certainly was not off our board," according to NBC SportsGroup. Owusu was taking part in a Stanford School of Medicine research project when he suffered at least one of his concussions. Researchers recorded impact data from players wearing high-tech mouthguards in an effort to gain a better understanding of the forces that cause the injury. Source: Read more: https://sportsillustrated.cnn.com/2012/writers/jim_trotter/04/25/draft.concussions/index.html#ixzz1tSyGvhE8 Questions/comments? contact Jean Rickerson at Jean@SportsConcussions.org Photo: (c) Maveric2003@creativecommons